Bill > SB521

This bill requires health insurance carriers to provide more robust notification to enrollees and the Insurance Commissioner about changes to their provider networks, which are the groups of doctors, hospitals, and other healthcare providers that a plan contracts with. Specifically, carriers must now notify enrollees not only about the termination of their primary care provider but also any behavioral health provider for whom they've received services in the last three months, and they must inform enrollees of their right to continue receiving care from these providers for up to 90 days if the termination is not due to fraud or misconduct. Carriers must also notify the Insurance Commissioner at least 60 days before a material change to their provider panel, such as the termination of a provider or health care facility, and provide updates until the termination is finalized, with potential fines for failing to do so. Furthermore, health systems, defined as hospitals and affiliated entities, must provide 90 days' notice to carriers before terminating contracts, and carriers must make a good-faith effort to notify affected patients at least 30 days before such a termination. For contracts entered into, renewed, amended, or continued on or after October 1, 2026, both carriers and health systems must adhere to the contract terms, including reimbursement, for at least 90 days after termination or non-renewal, unless they mutually agree otherwise and provide proper notice. The bill also establishes new special enrollment periods for individuals purchasing health insurance through the state's Individual Exchange or directly from carriers, allowing them to enroll outside of the regular open enrollment period if they or a dependent are pregnant or if their treating provider is terminated from their health plan's network, with these special enrollment periods lasting 90 days and becoming effective on the first day of the month following the qualifying event.

Budget and Finance

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/SB0521?ys=2026RS